Azilect (rasagiline)

Azilect tablets contain the active ingredient rasagiline mesilate, which is a type of medicine called a selective monoamine-oxidase-B inhibitor (MAOI-B). Rasagiline increases the levels of a substance in the brain called dopamine and is used in the treatment of Parkinson's disease.

What is it used for?

How does it work?

Azilect tablets contain the active ingredient rasagiline mesilate, which is a type of medicine called a selective monoamine-oxidase-B inhibitor (MAOI-B). Rasagiline increases the levels of a substance in the brain called dopamine and is used in the treatment of Parkinson's disease.

Dopamine is a substance known as a neurotransmitter. Neurotransmitters are found in the brain and nervous system and are involved in transmitting messages between nerves. These messages allow the normal functioning of the body. The neurotransmitter dopamine is known to be reduced or absent in the brains of people with Parkinson's disease, and this is thought to be the cause of the disease symptoms. The mainstay of treating Parkinson's disease is to replace dopamine in the brain.

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Natural dopamine released from nerve cells in the brain is normally broken down by an enzyme called monoamine-oxidase-B. Rasagiline works by blocking the action of this enzyme, which prevents the monoamine-oxidase-B from breaking down the dopamine. This results in an increased amount of active dopamine in the brain, and this reduces the symptoms of Parkinson's disease.

Rasagiline can be used on its own, or in combination with a medicine called levodopa to treat Parkinson's disease. Levodopa is converted into dopamine in the brain and therefore works by directly replacing the lost dopamine. Unfortunately, levodopa treatment tends to become less effective over time and patients tend to experience 'end-of-dose' deterioration, where the length of time that each dose of levodopa lasts becomes progressively shorter. Rasagiline can be used to prolong the effect of levodopa, because it stops the dopamine that is formed from the levodopa from being broken down in the brain. This extends the action of levodopa thereby reducing the 'end-of-dose' side effects.

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How do I take it?

One Azilect tablet should be taken once a day. Try to take your tablet at the same time each day - this will help you to remember it.

The tablet can be taken either with or without food.

If you forget to take a dose at your usual time you can take it later that day. However, if you forget a dose for the whole day just leave out that dose. Take your next dose as usual when it is due. Do not take a double dose to make up for a missed dose.

Warning!

Smoking may decrease the blood level of this medicine and could make it less effective.

Changes in behaviour, including impulse control disorders such as uncontrollable urges to gamble, increased sex drive, obsessive thoughts, compulsive shopping and binge eating, have been reported in people taking this medicine. If you think this medicine is affecting you in this way, you should consult your doctor.

Use with caution in

People with decreased liver function.

Not to be used in

People with severely decreased liver function.

People taking other monoamine oxidase inhibitor medicines or the painkiller pethidine (see end of page for more information).

This medicine is not recommended for children and adolescents under 18 years of age, as its safety and efficacy have not been studied in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine has not been studied in pregnant women. It should be used with caution during pregnancy, and only if the expected benefit to the mother is greater than any potential risk to the developing baby. Seek medical advice from your doctor.

It is not known if this medicine passes into breast milk. There is a possibility that it may decrease the production of breast milk. It should be used with caution in women who are breastfeeding and only if the expected benefits outweigh any potential risks. Seek medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Skin cancer was reported in some people taking this medicine in clinical trials. However, the manufacturer states that the data they collected suggests that Parkinson’s disease, and not any drug in particular, is associated with a higher risk of skin cancer (not exclusively melanoma). You should consult your doctor if you experience any suspicious skin changes.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

Rasagiline should not be taken by people who are taking any of the following medicines, as these combinations could cause serious side effects:

fluoxetine (or if you have taken fluoxetine in the last five weeks)

fluvoxamine

other monoamine oxidase inhibitors (MAOIs), for example selegiline for treating Parkinson's, the antibiotic linezolid, or MAOI antidepressants such as phenelzine, isocarboxazid or tranylcypromine

the painkiller pethidine

the herbal remedy St John's wort (Hypericum perforatum).

Treatment with any of the medicines listed above should not be started until at least 14 days after stopping rasagiline.

Antidepressants should be used with caution in combination with rasagiline. Consult your doctor or pharmacist for advice.

You should avoid taking medicines that contain any of the following ingredients while you are taking rasagiline (these are often found in over-the-counter cough, cold and flu remedies):

dextromethorphan

decongestants such as ephedrine, pseudoephedrine (nasal or oral).

The antibiotic ciprofloxacin may increase the blood level of rasagiline.

Entacapone may decrease the blood level of rasagiline.

Other medicines containing the same active ingredient

There are currently no other medicines available in the UK that contain rasagiline as the active ingredient.

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